Individual provider Active NPI

Brandynne Marie Fry Allgaier, FNP-C, APRN

  • Nurse Practitioner
  • Jacksonville, IL
National Provider Identifier
1477225993
Registry record updated Apr 2, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
209.024073 Issued in IL
Practice address
1515 W Walnut St
Jacksonville, IL 62650-1150
Phone
(217) 243-5313
NPI assigned
Oct 3, 2021
Last updated
Apr 2, 2024By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 2, 2024

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 209.024073 IL Primary

Addresses

Primary practice location

1515 W Walnut St
Jacksonville, IL 62650-1150

Mailing address

1515 W Walnut St
Jacksonville, IL 62650-1150
Phone (217) 243-5313

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20221024000980 IL Practitioner - Nurse Practitioner 9537535125 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Jacksonville Crnas IncGroup PAC ID 2961681523, 17 clinicians

Practice addresses (Care Compare)

1600 W Walnut
Jacksonville, IL 62650-1199
Phone (217) 245-9541

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Vitae Health Medical Illinois, PLLC CurrentSince Sep 15, 2022 Accepting new patients
Jacksonville Crnas Inc CurrentSince Apr 1, 2024 Accepting new patients
Collaborative Medical PLLC Nurse Practitioner CurrentSince May 6, 2024 Accepting new patients
Casey Family Chiropractic LLC PastSince Apr 17, 2020 Accepting new patients

Locations

303 E Wacker Dr
Ste 1127
Chicago, IL 60601
Phone (312) 328-2347

1021 N Church St
Jacksonville, IL 62650
Phone (217) 245-0894

1515 W Walnut St
Ste 6
Jacksonville, IL 62650
Phone (217) 243-5313

1600 W Walnut St
South Jacksonville, IL 62650
Phone (217) 245-7275

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1633219200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1712016000000",
    "number": "1477225993",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1515 W WALNUT ST",
            "city": "JACKSONVILLE",
            "state": "IL",
            "postal_code": "626501150",
            "telephone_number": "217-243-5313"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1515 W WALNUT ST",
            "city": "JACKSONVILLE",
            "state": "IL",
            "postal_code": "626501150",
            "telephone_number": "217-243-5313"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ALLGAIER",
        "first_name": "BRANDYNNE",
        "middle_name": "MARIE FRY",
        "credential": "FNP-C, APRN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-10-03",
        "last_updated": "2024-04-02",
        "certification_date": "2024-04-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "IL",
            "license": "209.024073",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jacksonville, IL

Sources for this page

Verify at the official NPI Registry.